Paracetamol (acetaminophen) and warfarin interaction: unraveling the pivotal role of the vitamin K cycle

Paracetamol (acetaminophen) and warfarin interaction: unraveling the pivotal role of the vitamin K cycle

Elaine M. Hylek

Boston University School of Medicine, Department of Medicine, Section of General Internal Medicine and the Clinical Epidemiology Unit, Boston, Massachusetts, USA

Summary

Analgesia poses a clinical challenge for patients taking
anticoagulants. Nonsteroidal anti-inflammatory drugs
impair platelet function and also interfere with
prostaglandin’s protective effect on the gastric mucosa. As a
result, these medications increase the risk of gastrointestinal
hemorrhage (1). In clinical practice, patients are advised to
avoid or limit use of these agents because of the added risk of
bleeding. Paracetamol (acetaminophen) is the antipyretic and
analgesic of choice for patients on anticoagulant therapy
because it lacks these adverse effects on platelets and prostaglandin.
Paracetamol is readily available and widely used. . . .